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Payment Integrity Quality Program Implementation Specialist I/II
Blue Cross of Idaho. Analyze, manage, and implement editing and auditing concepts and customizations .
Posted 9/16/2026full-timeMeridian • Idaho • United StatesJuniorMid-Level💰 $60,048 - $84,069 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong analytical skills and the ability to collaborate with internal and external stakeholders to drive process improvements in the health industry. Proficient in reviewing contracts and policy language to ensure compliance with claims processing standards.
Highest-signal resume keywords
Analytical SkillsHealth Industry ExperienceProcess ImprovementContract ReviewTechnical Assessment
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Soft Skills
CollaborationCommunication
Certifications & Qualifications
Bachelor's Degree
Industry Keywords
EditingAuditingClaims ProcessingPolicy LanguageFunctional Requirements
About the role
Key responsibilities & impact- Analyze, manage, and implement editing and auditing concepts and customizations
- Collaborate with multiple internal business partners to identify continuous process improvement opportunities
- Monitor editing and auditing programs for trends and process improvement opportunities
- Present issues, lead and/or participate in discussions, and develop conclusions with internal and external professionals
- Provide functional requirements and work with software developers to determine solutions for projects
- Review contracts and policy language to ensure claims processing results match contract and policy terms
- Prepare and present in-depth written technical assessments
- Perform other duties and responsibilities as assigned
Requirements
What you’ll need- Level I: 2 years’ analytical, health industry, or relevant experience
- Level II: 4 years’ analytical, health industry, or relevant experience
- Bachelor’s Degree or equivalent work experience
- Two years’ relevant work experience is equivalent to one-year college
- Ability to perform each essential duty satisfactorily
- Knowledge, skill and/or ability required to perform the essential duties
- Ability to perform essential functions with or without reasonable accommodation
Benefits
Comp & perks- annual incentive bonus (variable depending on company and employee performance)
- paid time off
- paid holidays
- community service and self-care days
- medical/dental/vision/pharmacy insurance
- 401(k) matching and non-contributory plan
- life insurance
- short and long term disability
- education reimbursement
- employee assistance plan (EAP)
- adoption assistance program
- paid family leave program